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Selecting optimal patients with gastroparesis for G-POEM procedure
  1. Ting Zheng,
  2. Michael Camilleri
  1. Gastroenterology, Mayo Clinic Rochester, Rochester, Minnesota, USA
  1. Correspondence to Professor Michael Camilleri, Gastroenterology, Mayo Clinic Rochester, Rochester, MN 55905, USA; camilleri.michael{at}mayo.edu

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In a very welcome article, Vosoughi and colleagues1 describe the experience from five tertiary centres (four in the USA, one in Brazil) regarding the outcomes of the gastric peroral endoscopic myotomy (G-POEM) procedure for the treatment of 80 patients with symptomatic gastroparesis refractory to standard medical therapy and confirmed by impaired gastric emptying (gastric retention >20% at 4 hours). The primary endpoint was clinical success, defined as at least one score decrease in the Gastroparesis Cardinal Symptom Index (GCSI) with ≥25% decrease in two subscales at 12 months. From this open-label, uncontrolled experience, the authors concluded that G-POEM was only modestly effective in patient with gastroparesis, with a clinical success rate of 56% at 12 months. However, serial assessment documented that the response to G-POEM was durable over the 12-month follow-up. This study also identified that baseline GCSI score >2.6 and baseline gastric retention greater than 20% at 4 hours, as well as responsiveness 1 month after the G-POEM procedure were independent predictors of clinical success 12 months after G-POEM.

The study has many strengths including the sample size of 80, of which 94% had completed 12-month follow-up, use of the validated GCSI score and subscales, and assessment of quality of life, using the 36-Item Short Form Questionnaire, at baseline and 1, 3, 6 …

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Footnotes

  • Twitter @JohnnyTingZheng

  • Contributors TZ and MC reviewed the literature, wrote the paper, revised and finalised the paper.

  • Funding MC’s research on gastroparesis is supported by grant R01-DK122280 from National Institutes of Health.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Commissioned; internally peer reviewed.

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